DESCRIPTION (provided by investigator): This project will link outpatient and hospitalization data to define rates of hospitalization, hospitalization for specific complications, re-hospitalization, and mortality for a large, low-income, urban cohort of diabetics. In addition, it will provide data on possible disparities in these outcomes based on gender and/or race/ethnicity, and compare the hospitalization experience of this low-income cohort with that of all hospitalized diabetic patients residing in the same city. We propose to link data from several existing databases to investigate multiple health outcomes for a large, inner-city population of patients with diabetes. The two primary data sources will be the clinical database maintained by the Philadelphia Department of Public Health Division of Ambulatory Health Services (AHS) and the hospital discharges database maintained by the Pennsylvania Health Care Cost Containment Council (PHC4). The AHS database includes data on all patient encounters in 8 neighborhoods health care centers operated by AHS, including up to 4 diagnostic codes per encounter and essential demographic information. The PHC4 database includes data on all hospital discharges in the Pennsylvania, including diagnostic and procedure codes and demographic information. Both databases include individual identifiers that make it possible to follow individuals' experiences over time for data from 1993 through 2001. In addition, we will link the data to death records maintained by the PDPH. Linking these databases will allow us to determine the rates and patterns of hospitalization for AHS patients with diabetes. It will also open up new opportunities to investigate risk factors for hospitalization, re-hospitalization, and specific complications and procedures. We anticipate that this research will provide preliminary data to support applications for funding for further studies involving medical record extraction and/or individual interviews to investigate additional clinical, social, and behavioral risk factors and outcomes. [unreadable] [unreadable]